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14 January 2012

Surgical Techniques Affect Outcome in Scoliosis Surgery

For patients with adolescent idiopathic scoliosis, eight factors correlate significantly with maintenance of kyphosis, according to a study published online Jan. 5 in Spine.

(HealthDay News) — For patients with adolescent idiopathic scoliosis (AIS), eight factors correlate significantly with maintenance of kyphosis, according to a study published online Jan. 5 in Spine.

Baron S. Lonner, M.D., from the New York University Hospital for Joint Diseases in New York City, and colleagues investigated the surgical and radiographic factors in AIS surgery that affect kyphosis maintenance, in a retrospective multicenter study of 269 patients. Participants had kyphosis of less than 22 degrees. Operative data were recorded, and a complete radiographic series was obtained for each patient before surgery, immediately after surgery, and at two years after surgery.

In multivariate analysis, the investigators found that maintenance of kyphosis at two years post-surgery was significantly associated with eight variables. Increased kyphosis at follow-up correlated significantly with anterior approach, elevated thoracic coronal curve, and a greater percentage of hooks in the construct. Hypokyphosis correlated with a larger number of levels fused, preoperative kyphosis, the percentage of screws in the construct, use of stainless steel rods, and percent decrease in the thoracic curve.

"Our multivariate analysis demonstrates that in patients with AIS who have thoracic hypokyphosis as part of their deformity, anterior approach, fusing as few levels as possible, and using a hybrid construct are associated with improved thoracic sagittal contour," the authors conclude.

The study was supported by corporate/industry funding; one or more authors disclosed financial ties to a commercial entity related directly or indirectly to the study.